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230 Meta analysis of low-dose aspirin in reducing risk of atherosclerosis cardiovascular disease in systemic lupus erythematosus patients
  1. RA Nugraha1,
  2. M Jonatan1,
  3. FF Alkaff1,
  4. A Awalia2 and
  5. R Yudiwati3
  1. 1Universitas Airlangga, Medicine, Surabaya, Indonesia
  2. 2Internal Medicine – Dr. Soetomo General Hospital, Rheumatology, Surabaya, Indonesia
  3. 3Universitas Airlangga, Biomedics and Biomolecular Medicine, Surabaya, Indonesia

Abstract

Background and aims Atherosclerosis Cardiovascular Disease (ASCVD) contributes to higher morbidity and mortality in SLE patients. Aspirin is known to be associated with a decrease in the incidence of thromboembolic events in general population, but its potential benefit in SLE patients has not yet been investigated. Thus, aim of this study is to discover whether aspirin has a significant protective effect on the risk of ASCVD in SLE patients.

Methods Twelve RCT studies identified from the Medline, Embase and Cochrane databases were selected with available individual patient-level data, reporting the use of low-dose aspirin in SLE patients. The primary outcome was the incidence of ASCVD in SLE patients treated with low-dose aspirin compared to those not treated with low-dose aspirin. The secondary outcome was frequency and duration of SLE exacerbation during a mean 7 years follow-up.

Results Pooled effect estimates were obtained using a random-effects model. Pooled Hazard Ratios (HRs) and 95% CIs were calculated using Bayesian hierarchical models. We pooled data from 2.135 subjects with 364 ASCVD events during a mean 7 years follow-up. Subgroup analysis showed a protective effect of low-dose aspirin against ASCVD, including CHD, TIA, stroke, and PAD (HR: 0.43 [95%CI: 0.20–0.93]) but not for SLE exacerbation (HR: 0.49 [95%CI: 0.22–1.11]).

Conclusions Meta-analysis shows significant decreased of ASCVD events by low dose aspirin among SLE patients. Low-dose Aspirin are considered safe and may be beneficial for thromboprophylaxis. Moreover, bigger studies are needed to provide a better recommendation for clinicians in using low-dose Aspirin in SLE patients.

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